Abbrevia(ons in Swedish Clinical Text -­‐ use by three professions Elin LÖVESTAM , Sumithra VELUPILLAI and Maria
a,
KVIST
a
b
b, c
Dept. of Food, Nutrition and Dietetics, Uppsala university, Uppsala, Sweden
Dept. of Computer and Systems Sciences, Stockholm University, Stockholm,
Sweden
b
Dept. of Learning, Informatics, Management and Ethics (LIME), Karolinska
Institutet, Sweden
c
Abbrevia(ons in clinical texts…
… are frequently used
… can be standardized or ad hoc
… are o@en ambiguous
2
Unstandardized and ambiguous abbrevia(ons…
… decreases pa(ent safety
… is an obstacle for pa(ents reading ther own EHR
3
Aim
To analyse the use of some abbrevia(ons by three professions:
•  Die((ans
•  Nurses
•  Physicians
4
Two different corpora:
A.  Diete(c corpus from Uppsala:
• 
• 
147 systema(cally collected notes by die((ans
About 30 000 words
A
B
B.  Subset from Stockholm EPR Corpus
• 
• 
• 
Diete(c notes by die((ans
9 516 625 words
Daily notes by nurses 13 925 899 words
Radiology notes by physicians 15 370 134 words
5
Extrac(ng and matching abbrevia(ons
1. Corpus A
A
2. Corpus B
•  Manual content analysis
•  Result: 266 unique abbrevia(ons
B
•  Tokenized •  Matched with the 266 abbrevia(ons
6
Context analysis
1. Corpus A
A
•  40 abbrevia(ons were selected
•  Classification
in categories
2. Corpus B
B
•  20 sentences randomly extracted for each abbrevia(on
7
Results
8 %
(n=21)
None: 9 %
3 %
5 %
(n=9)
(n=12)
72 %
(n=24)
(n=191)
0 %
1 %
(n=0)
(n=2)
3 %
(n=7)
Frequencies of shared abbrevia(ons (n=266)
8
Categoriza(on of abbrevia(ons found in corpus A
Categories
General non-­‐standardized
Corpus A
(n=266)
90
General standardized
12
General standardized, punctua(on mistakes
25
Food/meals
36
Medical assessment and interven(on
33
Diseases
18
Units
17
Ins(tu(ons/hospitals
16
Laboratory values
16
Health care professions
5
Body parts
0
Names of persons/products
0
Probable spelling mistakes
3
Categoriza(on of the 40 abbrevia(ons in corpus B
General
non-standardized
General
non-standardized
General
standardized
General
standardized
General
standardized,
punctuation
General standardized,
punctuation
mistakes
mistakes
Food/meals
Food/meals
assessment/ intervention
MedicalMedical
assessment/intervention
Dietitians (n=40)
Diseases
Diseases
Nurses (n=40)
Units
Units
Physicians (n=40)
Institutions/hospitals
Institutions/hospitals
Laboratoryvalues
values
Laboratory
professions
HealthHealth
carecare
professsions
Body parts
Body
parts
of persons/products
NamesNames
of persons/products
Probable spelling mistakes
Probable
spelling mistakes
0
5
10
15
20
25
30
Mul(ple meanings of abbrevia(ons found in corpus B
30
25
20
Number of
abbreviations
15
Dietitians
Nurses
Physicians
10
5
0
1
2
3
4
5
6
7
Number of meanings/abbreviation
Different meanings of the abbrevia(on ”gr”in Corpus B
Used by profession
Original expression
Die((an + nurse + physician
gram
Original expression in Swedish
gram
Nurse + physician
Celsius degree
grader
Die((an + physician
group
grupp
Die((an + nurse
(mes
gånger
Physician
angular degree
grader
Physician
level of disease
grad av sjukdom
Physician
due to
på grund av ( p gr a)
Nurse
probable spelling mistake
Different ways to abbreviate diabetes mellitus in Corpus B
Abbrevia(on
diab
Original expression
diabetes
Die((ans
Nurses
Physicians
118
965
158
dm
diabetes mellitus
432
38
290
DM
Diabetes Mellitus
597
69
4219
Diabetes Mellitus type 1
Diabetes Mellitus type 2
Insulin Dependent Diabetes Mellitus
71
0
0
39
0
0
416
0
36
DMT1
DMT2
IDDM
Conclusions
•  Ambiguous abbrevia(ons are common both within and between professions
•  Different professions seem to have different abbrevia(on cultures
This may lead to…
•  …misunderstandings between healthcare professionals
•  …misunderstandings between healthcare professionals and pa(ents reading their own pa(ent record
•  …difficul(es performing automated informa(on extrac(on from pa(ent records
Corresponding author: Elin Lövestam, [email protected]